Outcomes of patients with hematologic malignancies and COVID-19: a report from the ASH Research Collaborative Data Hub

Abstract

Coronavirus disease 2019 (COVID-19) is an illness resulting from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that emerged in late 2019. Patients with cancer, and especially those with hematologic malignancies, may be at especially high risk of adverse outcomes, including mortality resulting from COVID-19 infection. The ASH Research Collaborative COVID-19 Registry for Hematology was developed to study features and outcomes of COVID-19 infection in patients with underlying blood disorders, such as hematologic malignancies. At the time of this report, data from 250 patients with blood cancers from 74 sites around the world had been entered into the registry. The most commonly represented malignancies were acute leukemia (33%), non-Hodgkin lymphoma (27%), and myeloma or amyloidosis (16%). Patients presented with a myriad of symptoms, most frequently fever (73%), cough (67%), dyspnea (50%), and fatigue (40%). Use of COVID-19–directed therapies, such as hydroxychloroquine (n = 76) or azithromycin (n = 59), was common. Overall mortality was 28%. Patients with a physician-estimated prognosis from the underlying hematologic malignancy of <12 months at the time of COVID-19 diagnosis and those with relapsed/refractory disease experienced a higher proportion of moderate/severe COVID-19 disease and death. In some instances, death occurred after a decision was made to forgo intensive care unit admission in favor of a palliative approach. Taken together, these data support the emerging consensus that patients with hematologic malignancies experience significant morbidity and mortality resulting from COVID-19 infection. Batch submissions from sites with high incidence of COVID-19 infection are planned to support future analyses.

Newly Diagnosed Acute Myeloid Leukemia in a Patient With Severe SARS-CoV-2 Infection

“…Although the diagnosis of leukemia, in the aforementioned studies, was performed earlier than our case, the prognosis of patients was also poor. This is in accordance with recent multicenter studies reporting that cancer patients have been affected by COVID-19 during the pandemic in a rather similar incidence to the general population; however, the outcome of SARS-CoV-2 infection is significantly worse in patients with hematologic malignancies [ 14 , 15 ].…”

Therapeutic approach for severe COVID-19 and immunocompromised patients. A case series

“…Tumors and antitumoral therapy potentially compromise the immune system thus influencing the disease severity and prognosis. It has been reported that hematological malignancies have higher mortality for COVID-19 than general population [ 2 ]. A decrease in the innate antiviral response and chronic lymphopenia are common in neoplastic patients.…”

COVID-19 and Hematopoietic Cell Transplantation Center-Specific Survival Analysis: Can We Adjust for the Impact of the Pandemic? Recommendations of the COVID-19 Task Force of the 2020 Center for International Blood and Marrow Transplantation Research Center Outcomes Forum

“…Early reports about COVID-19 indicated substantially higher morbidity and mortality in HCT recipients than in the general population ( 1 , 2 , 3 , 4 , 5 , 6 ). Thirty-day mortality rates of 22-32% were seen ( 1 , 2 ).…”

“…Four categories of indirect factors on the centers that might affect center-specific performance were also identified: ( 1 ) COVID-19 burden; ( 2 ) locality of the center and patient; ( 3 ) impact of COVID-19 on center survival; ( 4 ) indirect effects of COVID-19 burden on a center's practices. COVID-19 Burden.…”